EHR 2.0: Thinking Outside the Cat Box

Zencat One of the potential dangers of limiting $17 B HITECH federal stimulus funds to electronic health records (EHRs) is the risk of locking-in outdated technologies. Let’s consider what this might mean.

If you think of today’s EHR technology as EHR 1.0, what might EHR 2.0 look like? This post presents a number of innovative ways to conceptualize EHR 2.0:

  • EHR as Platform + Applications
  • EHR as Clinical Groupware
  • EHR Integrated with PHR
  • EHR as Software-as-a-Service (SaaS)
  • EHR as a “Publish-Discover” Search Engine
  • EHR + Disease Management Services = Care Coordination
  • DRT-Enabled EHR

My point here is not to provide an exhausting listing of what’s possible, but simply to get you to begin to think about what’s outside the existing EHR box. These concepts are not mutually exclusive and you’ll see there’s overlap.

Let’s look at each of these innovative approaches.

How Should Fed HIT Dollars Be Spent? Cat vs. Dog POV.


“Where’s the single best place to get up to speed on how the Feds should  spend $20 billion to advance health information technology (HIT)?”

A colleague asked me this question a couple of days ago, and at first I hesitated.  Then it struck me — Matthew Holt’s The Health Care Blog has become the focal point for discussion of this critical topic.

Matthew’s very recent article — Cats & dogs: Can we find unity on health care IT change? — summarizes the two schools of thought that have emerged over the past two months.

His article is important and notable for a number of reasons:

  • He crystallizes the two emerging schools of thought — the dog vs. cat POV (see below)
  • He summarizes and links to many other key writings on the HIT spending topic
  • He suggests that the dog and cat POV can be reconciled — that there’s a middle road
  • He suggests several initial options to reconcile the differing schools of thought.  This discussion should continue.

If you’re interested in disease/care management, this is a topic you should be following closely. While the first decade of DM focused on a services based, call center model — the handwriting is on the wall that the next decade will focus much more on a technology based model.

Companies and organizations involved in disease/care management should be positioning themselves to take direct and indirect advantage of the Federal injection of funds.

Here’s Matthew Holt’s summary of the dog vs. cat perspectives: